冠心病患者肺炎衣原体DNA及抗体检测

目的:探讨肺炎衣原体(Cpn)与冠状动脉粥样硬化心脏病(CHD)之间的相互关系。方法:采用PCR和ELISA ,分别对2 0 0例经冠状动脉造影证实的冠心病患者和非冠心病对照组进行全血标本肺炎衣原体DNA和血清中抗肺炎衣原体IgG检测。结果:冠心病组肺炎衣原体DNA阳性率为4 3 4 0 % ,对照组阳性率为7 32 %。冠心病组肺炎衣原体IgG抗体阳性率为6 4 78% ,对照组阳性率为31 71%。两组肺炎衣原体DNA和IgG抗体阳性率差异均有显著性(P <0 0 1)。结论:肺炎衣原体感染与冠心病存在密切的关系     

巨细胞病毒感染时免疫功能的变化及其意义

目的　探讨巨细胞病毒感染时免疫变化及其意义。方法　以 2 0名CMV IgM(Cytomegalovirus immunoglobulinM)阳性的病儿为观察对象 ,另设对照组 30例。ELISA法检测柯萨奇B组病毒抗原 (CVB Ag)、IgM抗体 (CVB IgM)、巨细胞病毒IgM抗体 (CMV IgM)、EB病毒IgM抗体 (EBV IgM) ,单克隆抗体标记间接ABC免疫法检测外周血T细胞亚群。结果　CMV感染组的LAK细胞、NK细胞活性均明显降低 (P <0 .0 1)。合并其它感染原的CMV混合感染组CD3含量减少 ,CD8含量增加 (P <0 .0 5 ) ,CD4 CD8数值明显降低 (P <0 .0 1)。病毒混合感染并合并支原体感染组CD3含量减少 (P <0 .0 5 )、CD4 CD8数值、IgA含量明显降低 (P <0 .0 1)。结论　巨细胞病毒感染影响了T细胞亚群的平衡 ,在合并其他感染时天然免疫细胞功能下降和T细胞亚群紊乱更明显     

不孕不育妇女四项自身免疫抗体的研究

目的　探讨自身免疫抗体与不孕不育的关系。方法　ELISA法检测了 172例不孕妇女。结果　原发不孕和继发不孕组阳性率明显高于对照组 (P <0 .0 1) ,原发不孕组AOVAb(2 4 .7% )与AhCGAb(13.3% )有显著性差异 (P <0 .0 1) ,继发不孕组AEMAb((18.6 % )与AhCGAb(10 .2 % )、AOVAb(2 2 % )间有显著性差异 (P〈0 .0 1) ,原发不孕与继发不孕组间四项自身抗体均无差异 (P >0 .0 5 )。结论　自身抗体在不孕人群中有较高的发生率 ,应引起重视。     

冠心病患者肺炎衣原体感染的研究

目的 :探讨肺炎衣原体感染与冠心病之间的关系。方法 :采用微量免疫荧光方法检测 76例冠心病(包括急性心肌梗塞 )患者和 76例对照组患者的外周血肺炎衣原体ＩｇＧ、ＩｇＭ抗体 ;采用ＰＣＲ法检测以上所有病人的鼻咽拭子。结果 :两组患者ＩｇＧ抗体的几何平均滴度差异显著 (Ｐ <0 0 5)。ＩｇＧ、ＩｇＭ抗体阳性率在冠心病组 (包括急性心肌梗塞 )分别为 75 4%、2 3 1 % ,而在对照组分别为 52 1 %和 5 2 % ,差异均有显著 (Ｐ <0 0 5)。 1 52例患者中ＩｇＧ、ＩｇＭ抗体阳性率男性分别为 66 3%、1 5 1 % ,女性分别为 60 6%和1 3 6% ,男性略…     

人白细胞抗原DQB1基因与1型糖尿病相关性研究

目的　研究四川地区汉族人群人类白细胞抗原 (humanleucocyteantigen ,HLA)DQB1基因与 1型糖尿病 (type 1diabetesmellitus ,T1DM )发病年龄及糖尿病自身抗体的相关性。 方法　应用聚合酶链反应 序列特异性引物方法对 46例T1DM患者和 5 2名正常人进行HLA DQB1基因分型 ,并对T1DM患者以酶联免疫吸附法定性检测谷氨酸脱羧酶抗体 (glutamicaciddecarboxylaseantibody ,GADA)及抗胰岛细胞抗体 (isletcellantibody ,ICA)。结果　DQB1 0 2 0 1基因阳性率T1DM组高于对照组 (OR =18,P <0 .0 0 5 ) ;而DQB1 0 60 1、 0 60 2基因阳性率对照组高于T1DM组 (OR分别为 0 .0 7、0 3 1,P <0 .0 5 )。DQB1 0 60 2基因阳性率在发病年龄≥ 2 0岁T1DM组高于 <2 0岁组 (P <0 .0 5 )。携带DQB1 0 2 0 1基因的患者中 ,GADA阳性率明显高于此基因阴性的患者 (P <0 .0 2 5 )。结论　四川地区汉族人群中DQB1 0 2 0 1可能是 1型糖尿病的易感基因 ,而DQB1 0 60 2、 0 60 1是保护性基因 ,且DQB1 0 60 2基因的存在有可能推迟 1型糖尿病的发病 ;DQB1 0 2 0 1的阳性率与GADA阳性率正相关。     

BALB/c小鼠特异性免疫状况与中枢神经系统风疹病毒JR23株的感染

目的　探讨机体特异性免疫状况与中枢神经系统 (centralnervoussystem ,CNS)风疹病毒(rubellavirus,RV)感染的关系。方法　本研究选择BALB c小鼠 ,给予地塞米松和环磷酰胺药物后 ,经腹腔感染RVJR2 3株 ,于感染后第 2 1天检测动物的免疫功能 ,观察RV对CNS的侵袭性 ,分析两者之间的关系。结果　环磷酰胺药物组的动物细胞功能明显低于其他实验组 (P <0 0 5 ) ,地塞米松药物组、药物未干预的病毒感染组及阴性对照组之间差异无显著性 (P >0 0 5 )。CNS受染动物的细胞免疫功能明显低于CNS未受染动物 (P <0 0 0 1)。地塞米松、环磷酰胺和药物未干预动物组的CNSRV感染率分别为 6 0 % ,90 %和 5 0 %。各组感染动物RV特异性抗体生成差异无显著性 (P >0 0 5 )。结论　在机体尚未产生特异性抗体前 ,RV对CNS的感染与机体的细胞免疫状况有关     

脑梗死患者血清抗心磷脂抗体与白细胞介素-6水平的变化

目的 :观察脑梗死患者血清抗心磷脂抗体 (ACA)与白细胞介素 6(IL 6)水平的变化 ,并探讨其临床意义。方法 :采用ELISA法对 65例脑梗死患者血清ACA和IL 6进行检测 ,并与 5 8例健康者进行对照。结果 :脑梗死患者ACA结合指数与IL 6含量均显著高于正常对照组 (P <0 .0 1) ,其中多灶梗死组IL 6含量明显高于单灶梗死组(P <0 .0 1)。脑梗死患者IgG型ACA比IgA型和IgM型阳性率高。结论 :ACA和IL 6与脑梗死关系密切 ,可作为其危险性判断的检测指标     

青霉素类过敏反应病人血清中特异性IgE抗体

目的 :探讨青霉素类过敏反应与特异性IgE抗体的关系。方法 :采用放射过敏原吸附试验 (RAST)测定 3 97例青霉素过敏病人血清中 8种抗原决定簇(BPO PLL、PVO PLL、APO PLL、AXO PLL、BPA PLL、PVA PLL、APA PLL、AXA PLL)特异性IgE抗体。结果 :3 97例过敏病人中 ,特异性IgE抗体阳性率为 5 8.9% (2 3 4例 )。其中 ,男性组抗体阳性率显著高于女性组 (P <0 .0 5 )。在所检测的 8种特异性IgE抗体中 ,BPA IgE抗体阳性率 2 5 .44% (1 0 1例 )最高 ,PVA IgE抗体 2 5 .1 9% (1 0 0例 )次之 ,而APA IgE抗体 9.82 % (3 9…     

1816例孕妇孕期HBeAg、HCV、HIV、梅毒抗体筛查检测结果分析

目的孕妇孕期感染乙型肝炎、丙型肝炎、艾滋病、梅毒均可引起母婴垂直传播,其危害可伴随终生,尤其是孕期感染梅毒并在活动期还可引起早产、死胎等。方法为了解本地区孕妇上述疾病的感染情况,我们对2010年1月至12月间在我院正常孕期体检的1816例孕妇（检测组）及同期健康体检的1500例育龄妇女（对照组）的HBVM,抗HCV抗体;抗HIV抗体;梅毒抗体进行筛查检测。结果检测组与对照组乙肝HBsAg阳性（2.64%;3.53%）、抗HCV抗体阳性率（0.06%;0）、抗HIV抗体阳性率（0.11%;0）之间无统计学意义（P〉0.05）;而梅毒抗体检测结果分别为1.9%与0.27%,统计学有显著性差异（P〈0.05）。结论孕妇孕期四项感染性疾病的筛查可及时发现孕妇的感染情况并可采取相应的措施,对降低新生儿感染、减少和避免医务人员职业暴露风险有重要意义。     

阻塞性睡眠呼吸暂停综合征合并慢性阻塞性肺病患者血清中β1与M2受体自身抗体的变化

目的 :检测阻塞性睡眠呼吸暂停综合征 (OSAS)合并慢性阻塞性肺病 (COPD)即重叠综合征(overlapsyndrome ,OS)患者血清中 β1-肾上腺素能受体与M2 -胆碱能受体自身抗体的变化。方法 :应用酶联免疫吸附法 (ELISA)检测OS患者 2 6例、OSAS患者 32例、COPD患者 30例及正常人 2 8例血清中抗 β1与M2 受体的自身抗体。结果 :β1与M2 受体的自身抗体阳性率及滴度 ,OS组 (92 2 % ,5 7 7%及 1∶98,1∶6 7)明显高于OSAS组 (71 9% ,40 6 %及 1∶83,1∶30 )和COPD组 (70 0 % ,36 7%及 1∶79,1∶2 8) (P <0 0 5 ) ,OSAS和COPD组显著高于正常对照组 (2 5 0 % ,14 3%及 1∶2 0 ,1∶2 0 ) (P <0 0 1)。结论 :OS ,OSAS与COPD患者血清 β1与M2 受体自身抗体明显高于正常人 ,且以OS患者为著     

Serologic markers for Chlamydia pneumoniae in asthma.

BACKGROUND: Chlamydia pneumoniae infection has been reported as a possible etiologic agent in asthma, which in primary care settings often appears to be initiated by acute respiratory infections. OBJECTIVE: To determine if serologic markers for C. pneumoniae are associated with adult asthma that first became symptomatic after an acute respiratory illness (asthma associated with infection: AAWI). METHODS: Serum samples from 164 primary care outpatients, mean age 44 years, (68 with AAWI; 36 with atopic, occupational or exercise-induced asthma (non-AAWI); 16 nonasthmatic patients with acute bronchitis; and 44 asymptomatic nonasthmatic controls) were tested for the presence of C. pneumoniae-specific IgG and IgA antibodies. Levels of chlamydial heat shock protein 60 (CHSP60) antibody were also measured. Those positive for CHSP60 were tested for C. pneumoniae-specific IgE antibodies by immunoblotting. RESULTS: Statistically significant differences in IgG and IgA seroreactivity were noted between groups: acute bronchitis and AAWI had the highest levels (93% to 94% IgG seroreactivity, 69% to 75% IgA seroreactivity) whereas non-AAWI and asymptomatic controls had the lowest levels (61% to 84% IgG seroreactivity, 31% to 43% IgA seroreactivity, P < .02 after adjustment for age, sex and smoking). CHSP60 antibodies were significantly more prevalent in AAWI than in non-AAWI (19% versus 3%, P = .02). IgE antibodies against C. pneumoniae 60, 62, and/or 70 kD antigens were detected in 5 of 13 CHSP60 positive AAWI patients. Persistent IgG, IgA, and CHSP60 seroreactivities were noted in all seropositive asthma patients with serial serum samples. CONCLUSIONS: Serologic markers of C. pneumoniae infection were associated with acute bronchitis and with asthma that first became symptomatic following respiratory illness. Serologic responses to C. pneumoniae may be useful in the classification and diagnosis of asthma.     

Seroprevalence of chronic Chlamydia pneumoniae infection in patients affected by chronic stable asthma

Objective   To evaluate the seroprevalence of Chlamydia pneumoniae and age, gender and smoking habits in stable asthmatic patients.
Methods   Over a period of 3 months, 197 adult patients affected by intermittent-to-severe chronic asthma were enrolled from 16 respiratory disease units in the south of Italy. As a control group, we tested 185 healthy, non-asthmatic subjects matched for age and gender, recruited among hospital staff. All patients were submitted to clinical examination, spirometry and blood collection for C. pneumoniae serology. The presence of infection was investigated by microimmunofluorescence (Micro-IF Test) for C. pneumoniae -specific IgG, IgM and IgA antibodies.
Results   C. pneumoniae IgG titers ≥1 : 64 were detected in 30.4% of asthmatics and in 30.8% of controls. Correlation of age, gender and smoking habit with C. pneumoniae seropositivity was evaluated by linear regression analysis. Age was significantly associated with C. pneumoniae IgG titer ≥1 : 64 when seropositive asthmatics were tested. Moreover, C. pneumoniae seroprevalence was higher among smokers with a diagnosis of chronic asthma.
Conclusions   The seroprevalence of C. pneumoniae in stable asthmatics was comparable with the controls; therefore, the study does not support the association between C. pneumoniae antibody titers and stable asthma. However, the analysis for likely confounders such as age, gender and smoking status suggests a possible association of enhanced susceptibility to C. pneumoniae infection with age and smoking habitus.     

Measurement of sputum antibodies in the diagnosis of acute and chronic respiratory infections associated with Chlamydia pneumoniae.

The aim of this study was to develop methods for the measurement of sputum antibodies in the laboratory diagnosis of acute and chronic lower respiratory tract infections caused by Chlamydia pneumoniae. Paired serum specimens, sputum specimens, and pharyngeal or nasopharyngeal swabs were obtained from 97 patients; 51 of them had community-acquired pneumonia, and 46 had chronic obstructive pulmonary disease (COPD). C. pneumoniae-specific serum immunoglobulin G (IgG), IgA, and IgM antibodies were measured by the microimmunofluorescence (micro-IF) test. For sputa, specific IgA and IgG antibodies were measured by the micro-IF test and secretory IgA (sIgA) was measured by enzyme immune assay (EIA) with C. pneumoniae elementary bodies as the antigen. Sputum IgA and sIgA antibodies to C. pneumoniae were found, respectively, in 52 and 51% of the COPD patients. Elevated levels of stable serum IgG and IgA antibodies (IgG titer of > or = 128 and IgA titer of > or = 40), suggesting chronic infection, were found in 54% of the COPD patients. The sensitivity for the sputum IgA micro-IF test compared with elevated serum antibody levels was 87.5%, and that for the sputum sIgA EIA was 88%; the respective specificities were 90 and 95%. Acute C. pneumoniae infection was diagnosed in seven pneumonia patients, and two (29%) of these patients were positive by sputum EIA antibody measurements. Two pneumonia patients without acute infection had stable elevated IgG and IgA levels in their sera, and both of them were sputum antibody positive. We conclude that the measurement of IgA antibodies to C. pneumonia in sputum is a useful additional diagnostic tool for chronic C. pneumoniae infections.     

Performance of three microimmunofluorescence assays for detection of Chlamydia pneumoniae immunoglobulin M,G, and A antibodies

The microimmunofluorescence (MIF) test is considered the "gold standard" for laboratory diagnosis of acute and chronic Chlamydia pneumoniae infection. The performance of a MIF test based on C. pneumoniae antigen from Washington Research Foundation (WRF) was compared with those of assays from Labsystems (LAB) and MRL Diagnostics (MRL) by investigation of sera from three groups of patients: group I, 83 sera from 28 patients with atypical pneumonia; group II, 37 sera from 16 patients with acute C. pneumoniae or Chlamydia psittaci respiratory tract infection confirmed by PCR or culture; group III, 100 sera from 100 persons enrolled in the Copenhagen City Heart Study. The accordance among the results of the WRF assay and the two commercial assays was excellent for the immunoglobulin M (IgM) antibody detection rate (98%). The accordance in detection rates for IgG and IgA antibodies in sera from patients with acute infections was acceptable (87 and 88%), and in sera from group III, it was excellent (95 and 97%). The determinations of endpoint titers were reproducible with <1 dilution step difference for all three methods, except that the mean IgM antibody titer found by the LAB assay was almost 2 dilution steps higher than that found by the other two methods. Although the three assays use different C. pneumoniae strains as antigens, the detection rates and IgG and IgA endpoint titers were similar. The difference in endpoint titers of IgM antibodies is of no major concern, as the diagnosis of acute C. pneumoniae infection rests on the presence of IgM antibodies, not on their level.     

Low prevalence of Chlamydia pneumoniae in adults with community-acquired pneumonia

The incidence of community-acquired pneumonia (CAP) due to Chlamydia pneumoniae was determined in a prospective study of 546 adult patients with CAP included in the German CAP Competence Network (CAPNETZ) project. Three different PCR protocols for detection of C. pneumoniae in respiratory specimens were compared by a multicenter, inter-laboratory comparison involving three laboratories. A case was defined as a patient with a respiratory sample positive by PCR in at least two laboratories. CAP was caused by C. pneumoniae in 5/546 cases (0.9%). Antibody testing by microimmunofluorescence was done in 376 of 546 patients. All patients were negative for IgM antibodies. In the five PCR-positive patients, neither specific IgG nor IgA antibodies were found. Patients with CAP caused by C. pneumoniae had a lower median age (36 years) than the general study population (62 years). C. pneumoniae is currently a rare cause of CAP in adult patients in Germany. Analysis of a single serum sample is not useful for diagnosis of acute C. pneumoniae infection in CAP.     

Correlation between rises in <Emphasis Type="Italic">Chlamydia pneumoniae</Emphasis>-specific antibodies,platelet activation and lipid peroxidation after percutaneous coronary intervention

We recently showed that Chlamydia pneumoniae activates platelets in vitro, with an associated oxidation of low-density lipoproteins. The aim of this study was to investigate whether C. pneumoniae is released during percutaneous coronary intervention (PCI) and, thereby, causes platelet activation and lipid peroxidation. Seventy-three patients undergoing coronary angiography and following PCI or coronary artery bypass graft (CABG) and 57 controls were included in the study. C. pneumoniae antibodies, serotonin and lipid peroxidation were measured before and 24 h, 1 month and 6 months after angiography. The results show that serum C. pneumoniae IgA concentrations were significantly higher in patients than in the controls. Furthermore, in 38% of the C. pneumoniae IgG positive patients, the C. pneumoniae IgG concentration increased 1 month after PCI. The levels of C. pneumoniae IgG antibodies 1 month after PCI correlated with plasma-lipid peroxidation (r = 0.91, P < 0.0001) and platelet-derived serotonin (r = 0.62, P = 0.02). There was no elevation in the total serum IgG 1 month after PCI. In conclusion, the present results suggest that PCI treatment of coronary stenosis releases C. pneumoniae from the atherosclerotic lesions, which leads to platelet activation and lipid peroxidation.     

Chlamydia pneumoniae-Specific Cell-Mediated and Humoral Immunity in Healthy People

In this work, cell-mediated immunity to Chlamydia pneumoniae was studied in 157 healthy individuals using lymphoproliferative assay and serum antibodies were analysed by microimmunofluorescence techniques. The C. pneumoniae- specific IgG antibodies were elevated more frequently and the geometric mean titres for IgG (67.5 versus 44.1; P  = 0.05) and IgA (14.9 versus 11.3; P  = 0.025) antibodies were significantly higher in males than in females. However, no gender-dependent differences were observed in cellular reactivity to C. pneumoniae, since the median cellular responses were similar (stimulation indices 7.5) in men and women. Although the cell-mediated and humoral responses to C. pneumoniae did not correlate clearly, elevated IgG antibodies were associated with slightly higher lymphocyte proliferation in comparison to all subjects (15.5 versus 7.5) and significantly stronger in comparison to those with persistently elevated IgA (> 80) antibodies (15.5 versus 3.5; P  = 0.023). Further studies are needed to evaluate a possible role of reduced cellular reactivity in the cause of chronic C. pneumoniae infection.     

CHRONIC CHLAMYDIA PNEUMONIAE INFECTION AND BRONCHIAL ASTHMA: IS THERE A LINK?

Purpose: Besides well-defined environmental causes, accumulating evidence suggests that respiratory tract infections play an important role in the pathogenesis of asthma. Among these Chlamydia pneumoniae infection has been discussed as possibly inducing the development of asthma. Methods: This study was designed to investigate the presence of anti chlamydial IgG, IgA, and IgM antibodies by ELISA in serum samples of 60 adults with a clinical history of asthma and 100 healthy age and sex matched controls. All the samples positive for Chlamydial genus specific IgG antibodies were then subjected to Chlamydia pneumoniae species specific IgG antibody ELISA. Results: The IgG anti chlamydial antibody-positivity rate in the patients with bronchial asthma (80%) was significantly higher in all age groups than that in the healthy age and sex matched controls (59%). No significant association was observed for IgA and IgM anti chlamydial antibodies. C. pneumoniae species specific IgG antibody seroprevalence was also found to be significantly higher in all age groups in comparison to controls (61.66% vs 38%). Conclusions: Serological evidence of chronic infection with C. pneumoniae was more frequent in patients with asthma compared with control subjects. Our results support the correlation of bronchial asthma and chronic infection with C. pneumoniae in Indian population.     

Mucosal immunity to Pseudomonas aeruginosa alginate in cystic fibrosis.

Patients with cystic fibrosis commonly acquire chronic pulmonary infection with alginate-producing Pseudomonas aeruginosa. The infection remains localized at the mucosal surfaces of the airways. Using enzyme-linked immunosorbent assays immunoglobulin concentrations and titers of specific antibodies to purified P. aeruginosa alginate and to P. aeruginosa sonicated antigens were measured in tears, saliva, sputum and serum. CF patients had significantly higher concentrations of IgG, IgA and SIgA in serum and saliva than controls. They also had significantly higher levels of specific antibodies to alginate and sonicated antigen in secretions and serum. Local production of IgA, IgG and IgM antibodies to P. aeruginosa was demonstrated. Only a minor proportion of specific IgA antibodies were present as secretory IgA in tears, saliva and sputum. The ratio of alginate-specific SIgA to specific monomeric IgA in sputum was significantly lower than the similar ratio in saliva, whereas the same ratio for specific P. aeruginosa sonicate antigens was found in saliva and sputum.     

Immunoglobulin A and immunoglobulin G antibody responses to alginates from Pseudomonas aeruginosa in patients with cystic fibrosis.

Patients with cystic fibrosis have a high prevalence of mucoid, alginate-producing Pseudomonas aeruginosa that causes chronic infection of the mucosal surface of the lungs. We developed enzyme-linked immunosorbent assays (ELISAs) for determination in serum of immunoglobulin A (IgA) and IgG antibodies to alginate purified from P. aeruginosa and an ELISA for detection of IgA antibodies to a polyvalent P. aeruginosa standard antigen. Absorption experiments indicated that the assays were antigen and antibody specific and had analytical variations that ranged from 7 to 19%. Serum samples from 207 patients with cystic fibrosis, 100 healthy children, and 94 healthy adults were examined. The patients responded to P. aeruginosa infection with early IgA and IgG antibody responses that were significantly higher than in controls and noncolonized patients. Analysis of paired serum samples showed that infected patients had an increase in specific IgG and IgA antibodies that was significantly higher than in noncolonized patients. The serological data were analyzed for correlation with clinical condition; poor lung function was significantly associated with increased levels of IgA and IgG antibodies to P. aeruginosa alginate and to the standard antigen and with a relative excess of IgA antibodies to the standard antigen compared with IgA antibodies to P. aeruginosa alginate. The assays showed high predictive values if positive, but a negative test did not exclude infection, and the ELISAs should not be used for diagnostic purposes. Mucoid strains were present initially in the sputa of 28 of 54 infected patients with paired serum samples. These patients had a significant increase in anti-alginate antibodies, but it was not different from the increase seen in patients infected only with nonmucoid strains. Therefore, alginate may also be produced in vivo by nonmucoid P. aeruginosa. The study showed that early formation of IgA and IgG antibodies to P. aeruginosa alginate did not prevent development of chronic infection and that P. aeruginosa-specific IgA antibodies correlate with poor lung function.